Introduction to Joint Pain

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Arthritis

Arthritis is the nation’s most common chronic health problem and is the leading cause of disability among those over age fifteen. Technically speaking, the word arthritis means “inflammation of a joint,” but while some forms of the disease cause a lot of inflammation, others trigger little or none. Broadly speaking, arthritis encompasses some one hundred diseases that attack the joints, from osteoarthritis to rheumatoid arthritis and from gout to ankylosing spondylitis.

In its various forms, arthritis afflicts some forty-six million Americans.

Chronic pain, obesity, and arthritis are locked in a vicious circle, with each able to make the others worse. It can go like this: You enter your forties with a little arthritis in your knees, you gain some weight as your metabolism slows, this puts more pressure on your knees and worsens your arthritis, you stop playing racquetball and cut back on your treadmill time because of the pain, now you’re burning even fewer calories, so you gain more weight, and so on.

Adding to the misery, in some forms of arthritis—including the most prevalent, osteoarthritis—an additional problem called glycation develops. During glycation, excess glucose circulating in the body binds to certain proteins and fats in the tissues, creating harmful substances called advanced glycation end products, or AGEs.

Medical researchers believe that this glycation reaction causes some of the major detrimental changes of aging. Glycation “cross-links” proteins in the body, deforming them and making them less elastic and flexible. On the surface of the body, this cross-linking and deformation shows up as wrinkles. Inside the body, it causes numerous problems including hardening of the arteries, degeneration of the central nervous system, inflammation, and stiff joints. The joints become stiff because the cartilage, which cushions and protects the ends of bones, is made up of collagen, which is susceptible to glycation. In theory, the more sugar that binds to the proteins in the collagen, the stiffer the cartilage will get, and therefore the more painful it will be to move the joint.

Periods of elevated blood sugar increase the rate of cartilage glycation, so it’s important to keep blood sugar levels under control. You can use the glycemic index when planning meals to help you select your foods properly and avoid the harmful blood sugar spikes that encourage glycation.

About the author

Dr. Peter Abaci

Bay Area Pain and Wellness Center: A Prospira Center of Excellence

Peter Abaci, MD, is certified in anesthesia and pain management by the American Board of Anesthesiology. He serves as the Medical Director of the nationally recognized Bay Area Pain and Wellness... View Articles